Humanitarian Health Action

Gaza Strip Health Cluster Weekly Bulletin No 2 - 4 February 2009

Highlights

Shareef Sarhan/Gaza - WHO

The Gaza Health Cluster Bulletin provides an overview of the health sector response to the Gaza crisis.

  • Flash Appeal for Gaza launched in Geneva on 2 February 2009
  • Health Cluster compiling comprehensive report on health needs
  • Most health facilities have resumed normal activities
  • Detailed health sector recovery plan being drafted

HEALTH ASSESSMENT

In spite of the devastation, most health facilities have resumed normal activities, with immunization and other public health programmes up and running again. Although most facilities have been restocked with drugs and supplies, urgently-needed psychotropic drugs remain in short supply, and there is a critical lack of spare parts for medical machinery. A comprehensive assessment of all medical equipment will need to be undertaken as soon as possible.

Electricity supplies are back to pre-emergency levels. Although water supplies have improved, an estimated one million people remain without adequate access to safe water.

Some agencies have reported problems obtaining access to patients. Conversely, many patients are themselves unable to access health facilities.

The Flash Appeal for Gaza was launched on Monday 2 February. It calls for US$613 million to cover requirements for the next six to nine months in critical areas such as food, water, sanitation, health care and shelter, as well as support to basic services such as education. Health sector needs account for US$48 million.

Priority needs and gaps include:

Case management:
  • Patients with trauma injuries are at risk of complications and permanent disability due to lack of appropriate follow up.
  • The suspension of treatment and delayed access to health care for patients with chronic diseases may result in complications and excess mortality.
  • There is a risk of diarrhoeal disease outbreaks from water- and food-borne diseases due to a lack of clean water and sanitation and the weak public health surveillance system.
  • There is an increased risk of long-term mental health problems as a result of the conflict and the ongoing insecurity. Many vulnerable groups or individuals have reduced coping mechanisms and may not have access to appropriate services or support networks.
  • The slow deterioration of the population's health and nutritional status, the worsening socio-economic and security conditions and the reduced quality of health care may lead to increased morbidity and mortality.
  • Lack of access to specialized tertiary care.
Coordination of supplies and staff:
  • Between 27 December 2008 and 1 February 2009, a total of 4314 metric tons of medical supplies was sent through the Rafah border in Egypt. Most donations have not yet been unpacked and documented. There will be a surplus of many items.
  • The Palestinian Ministry of Health (MoH) has issued guidelines documenting the procedures for donating and delivering medical supplies for Gaza. The MoH has prepared a list of urgently-needed medical equipment.
  • The MoH has also prepared lists of non-emergency drugs and disposable items needed for 2009. Donors are asked to donate the requested quantity of items on the list rather than contribute partial quantities of several items.
  • Health Cluster partners have asked for a meeting with the Minister of Health in order to explore ways of further improving coordination of medical supplies and staff.
Needs assessment:
  • Most Health Cluster partners have completed rapid needs assessments, using individual agency templates. WHO will compile a comprehensive health needs assessment report based on the contributions of respective agencies. The report will be used to draft the health sector input for the "UN Early Recovery Rapid Damage and Needs Assessment Report".

COORDINATION

Health Cluster
  • WHO, as lead agency of the Health Cluster, is convening bi-weekly meetings in Ramallah and Jerusalem bringing together representatives of UN agencies, national and international nongovernmental organizations (NGOs) and donors. The meetings will take place once a week as of 5 February
  • Health Cluster members have stressed the need to improve coordination between the health authorities in Ramallah and Gaza. Internal Health Cluster coordination between Jerusalem and Gaza also needs to be improved.
  • WHO has prepared and disseminated a table tracking all health sector activities (the "Who is doing What, Where and When" matrix).
  • WHO has prepared a first draft of the health sector input for the "UN Early Recovery Rapid Damage and Needs Assessment Report", and has circulated it to all partners.
Palestinian Ministry of Health

WHO continues to work closely with the MoH in Ramallah and is organizing meetings to discuss specific topics on behalf of Health Cluster partners.

FILLING GAPS

Immunization
  • Médecins du Monde (MDM) is helping the MoH resume vaccination services at the Al Atatra primary health care (PHC) centre.
  • UNICEF is supporting immunization services in PHC centres managed by the MoH.
Drug and medical supplies
  • Médecins sans Frontières (MSF) has donated drugs, vaccines and medical material to all MoH hospitals in Gaza. MSF has also made donations to UNRWA schools and to Caritas.
  • Islamic Relief is donating drugs and medical supplies.
  • The International Medical Corps (IMC) is planning to donate emergency health kits, safe delivery kits and other items, but has reported difficulties getting supplies into Gaza.
  • The International Organization for Migration (IOM), which is currently supporting the Gaza crisis from the Egyptian side of the border, has put a hold on medical donations until there is more information on the supplies that are needed.
  • Medical Aid for Palestinians (MAP) is working with community-based organizations and distributing emergency materials, nutritional supplementary kits, hygiene kits and other items. MAP has produced a situation report on the Central Drug Store in Gaza.
  • UNICEF is donating medical and nutritional supplies to NGO partners.
  • WHO is providing technical assistance to the drug supply management system, in full collaboration with MDM and MAP.
  • UNFPA has donated emergency reproductive health equipment, supplies and medicine.
  • CARE has donated drugs, medical material and equipment to hospitals and clinics in various locations around the Gaza Strip.
Rehabilitation of health infrastructure
  • IOM is planning reconstruction activities.
Water and sanitation
  • GlobalMedic has donated 50 tracer units, 10 million water purification tablets and 250 000 units of oral rehydration salts.
  • CARE-UK has a team of 18 national staff supporting water and sanitation activities.
Mental health
  • MSF mental health teams are currently debriefing and planning 10 consultations per day for post-traumatic stress disorders.
  • MDM is assessing mental health needs in medical and paramedical staff.
  • IMC is planning mental health services. Its team of ten general practitioners and nurses in Gaza have all been trained in mental health support.
  • IOM is also planning to offer psycho-social support once it enters Gaza.
Primary and reproductive health care
  • The United Nations Relief and Works Agency (UNRWA), which has 9,000 staff in Gaza, is running 18 primary health care (PHC) centres.
  • UNICEF is focusing on the Integrated Management of Childhood Illness programme and nutritional services in 4 PHC centres, as well as supporting 10 neonatal units in MoH hospitals.
  • The United Nations Population Fund (UNFPA) is supporting emergency obstetric care, and helping rehabilitate health facilities.
  • MSF is seeing an average of 70 patients a day at the paediatric hospital.
  • The Health Cluster will discuss with the MoH the possibility of offering medical services free of charge at PHC centres managed by the MoH.
  • IMC is discussing with the Director of PHC in Gaza the possibility of delivering PHC services through mobile clinics.
  • Save the Children is conducting a needs assessment on maternal and newborn care.
  • MDM is supporting 11 PHC clinics. This includes refurbishing material, assessing needs and distributing basic first aid kits.
  • The Swedish Organization for Individual Relief is supporting child care services.
  • Mobile teams from Merlin are supporting 90 MoH PHC facilities, and undertaking outreach activities to follow up pregnant women not attending health facilities. 70 women volunteers from Merlin are conducting health education activities. Merlin is also supporting school education programmes on health, hygiene and nutrition.
  • Health Workers Committee is supporting PHC and women and child health care in several hospitals and clinics.
  • Terre des Hommes has purchased a mobile clinic to be donated to the Palestinian Medical Relief Society.
  • SC Alliance is conducting health and nutrition needs assessments at community level, and advocating for breastfeeding.
Medical teams
  • Additional MSF staff entered Gaza in mid-January with 2 inflatable hospital tents.
  • MSF reports it is having difficulties obtaining access to patients. Moreover, many patients themselves are unable to access health facilities.
  • MSF is treating around 80 patients a day in Khan Younis and Gaza City post-operative clinics. It has treated another 353 patients (including 135 war-wounded) at home.
  • There are too many foreign medical staff, particularly in Shifa hospital.
  • GlobalMedic's 3-person team is providing support to Muslim Aid and other national NGOs. GlobalMedic is also providing medical support to the United Nations Mine Action Service team.
  • MAP is assigning a plastic surgeon and an orthopaedic surgeon to Gaza.
  • 18 national staff from CARE-UK are supporting primary and secondary health care.
  • A team from Chaîne de l'Espoir is on standby, waiting to enter Gaza.
  • WHO is supporting the coordination and entrance of two Argentinean surgeons to be deployed to Gaza European Hospital.
Disabilities
  • MDM is compiling lists of emergency orthopaedic surgery material needs.
  • Handicap International has 5 mobile teams working at various locations in Gaza.
  • Mercy Corps has donated material.
  • Diakonia and the Norwegian Association of Disabled are supporting the implementation, through the National Society for Rehabilitation' in Gaza, of a large-scale community-based rehabilitation programme covering 50% of the population. They are also supporting Al Wafa Rehabilitation Hospital.
  • Hagar is providing home care for the disabled, as well as equipment and support to Al Rafah hospitals and Palestinian NGOs in camps.
Referrals and evacuations
  • MSF is conducting triage for post-operative care and corrective surgery (around 6-10 patients a day), and referring patients to ICRC and Jordanian Field hospital.
  • The Palestinian Red Crescent Society (PRCS) has provided 49 ambulances to help with patient referral and evacuation.
  • WHO was supporting referrals and evacuations in 2 triage hospitals (Kamal Edwan Hospital and Abu Yousif Al Najjar Hospital)

The latest "Who is doing What, Where and When" matrix is attached.

CAPACITY BUILDING

  • Welfare Association is supporting 17 Palestinian NGOs with training, outreach and community-based services.
  • IMC is conducting mental health training for national health staff.
  • MDM is training operating theatre nurses in Nasser hospital.

REGIONAL AND INTERNATIONAL RESPONSE

  • The Government of Jordan has donated a field hospital.
  • The French Consulate has donated beds, medicines and supplies, and is deploying a medical team.
  • The Italian Government has donated drugs, supplies and generators for hospitals and PHC centres.
Shareef Sarhan/Gaza - WHO
For more information, please contact:

Tony Laurance, Head of Office WHO OPT
Tel: +97225400595, email: tla@who-health.org

Patricia Kormoss, Health Cluster Coordinator
Tel: +972547179032, email: kormossp@who.int

Chiara Stefanini, Health & Human Rights Officer
Tel: +97225400595, email: cst@who-health.org

Dr Mahmoud Daher, WHO Technical Officer (Gaza)
Email: mda@who-health.org

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